Proportion of outpatient reimbursement for children's medical insurance in Wuxi

The proportion of standard medical insurance payment is co-ordinated, and the maximum payment is 60% 40%14,880 yuan for the first-level medical institution in 200 yuan, 50% 50% 120265438 for the second-level medical institution in 300 yuan+40% 60% 9,760 yuan for the third-level medical institution in 0 yuan, 600 yuan. For example, suppose that Li 202 1, an insured resident, is designated as a first-class urban resident. The items of medication and diagnosis and treatment belong to the scope of "three catalogues". Among them, 5,000 yuan exceeding the annual maximum payment limit is paid by individuals, and the rest is 202 10 yuan. After excluding the 200 yuan Qifubiaozhun of first-class medical institutions, the total payment amount is 14880 yuan (the highest amount that can be paid this year), and liying, who is hospitalized this time, bears 156544. There are as many hospitalizations (different levels of medical institutions) in one year. Of course, the reimbursement ratio and deductible line are different in different places and hospitals. The above answers about the reimbursement ratio of children's social security medical insurance can only be used as a reference.

Legal objectivity:

Article 28 of the Social Insurance Law conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and shall be paid by the basic medical insurance fund in accordance with state regulations. Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.